Dispensing Diversity
Navigating the Workplace as an LGBTQIA+ Pharmacist
Foreword:
I recently had the privilege of presenting to the Pharmacist Support Services (PSS) volunteers on the challenges and experiences faced by LGBTQIA+ pharmacists in the workplace. As someone deeply committed to fostering inclusivity and advancing health equity, it was an opportunity to not only share my personal journey as a transgender woman in pharmacy but also shed light on the systemic issues affecting our profession.
In this post, I’m sharing the transcript of my presentation, which explores a range of topics—from microaggressions and patient interactions to the mental health impacts and the critical need for diversity, equity, and inclusion in pharmacy. I hope that by reflecting on these issues, we can start meaningful conversations that lead to lasting change in our workplaces and the wider healthcare system.
Before diving into pharmacy-specific issues, I want to quickly highlight the importance of inclusive language. A quick refresher can help ensure we're all on the same page:
LGBTQIA+ stands for Lesbian, Gay, Bisexual, Transgender, Queer/Questioning, Intersex, Asexual, with the "+" acknowledging the spectrum of identities beyond these categories.
Pronouns and names – Respecting a person’s chosen name and pronouns is one of the simplest yet most impactful ways to foster inclusion.
Gender Identity vs. Sexual Orientation – Gender identity is about who someone is, while sexual orientation concerns who they are attracted to. These are separate, though often conflated, topics.
If anyone would like more resources on inclusive language, I am happy to provide them after the presentation.
Why We Should Support LGBTQIA+ Pharmacists
Before we dive deeper into the challenges, I want to ground us in the “why.” Why does this matter? Why should PSS volunteers — and all of us — care deeply about supporting LGBTQIA+ pharmacists?
LGBTQIA+ patients, as well as individuals from other minority groups—such as those from culturally diverse backgrounds, different racial groups, and especially women—actively seek out LGBTQIA+ pharmacists because they feel more at ease discussing sensitive healthcare concerns with someone who shares or understands their experiences. This sense of safety is rooted in several key factors:
Reduced Fear of Judgment – LGBTQIA+ individuals often face stigma when discussing sensitive health issues like hormone replacement therapy (HRT), PrEP, HIV treatment, reproductive health, or gender-affirming care. Knowing their pharmacist is part of or allied with the LGBTQIA+ community helps ease concerns about discrimination.
Enhanced Cultural Competency – LGBTQIA+ pharmacists are more likely to understand the intricacies of gender identity, sexual health, and the unique challenges LGBTQIA+ patients face within the healthcare system. This leads to more informed recommendations and fewer assumptions.
Trust and Representation – For patients who have felt dismissed or misunderstood by the medical system, seeing an LGBTQIA+ healthcare professional can be deeply affirming. Representation is crucial, and knowing a pharmacist has a shared lived experience fosters trust and open dialogue.
A More Supportive Environment – Many LGBTQIA+ individuals have faced negative healthcare experiences, such as being misgendered or denied care. LGBTQIA+ pharmacists can help create a more inclusive, welcoming space where patients feel comfortable advocating for their health.
Word-of-Mouth and Community Networks – Within many LGBTQIA+ communities, word spreads quickly about healthcare providers who are affirming and knowledgeable. When a pharmacist is known to be accepting, patients are more likely to recommend them to others.
For these reasons, having visible, out LGBTQIA+ pharmacists is not just about representation; it directly improves patient care and builds a more inclusive healthcare system.
Microaggressions
Microaggressions—subtle, often unintentional acts of exclusion—are prevalent in pharmacy. Inappropriate jokes, assumptions about gender and sexuality, and social exclusion may seem minor, but when left unchallenged, they normalise discrimination and foster environments where more overt harm can thrive.
For LGBTQIA+ pharmacists, this can mean feeling unsafe, avoiding leadership roles, or even leaving the profession. Beyond the personal impact, this weakens diversity and affects patient care—an inclusive workplace leads to better health outcomes.
A non-binary pharmacist repeatedly reports misgendering, but management dismisses it as a misunderstanding. Over time, staff see that misgendering is tolerated, discouraging trans and gender-diverse employees from speaking up or feeling valued.
To combat this, workplaces must enforce zero tolerance for discrimination, empower staff to challenge inappropriate behaviour, and ensure policies have real consequences. Training alone isn’t enough—systemic change and accountability are key to fostering a safe, inclusive profession where all pharmacists can thrive.
Patient Interactions
A common challenge is responding when a customer refuses service from an LGBTQIA+ pharmacist. This can be distressing and isolating for the pharmacist involved.
A lesbian pharmacist has had patients refuse her service upon learning of her identity. This type of discrimination reinforces the need for strong anti-discrimination policies in workplaces.
Managers should say, "All our pharmacists are trained professionals, and we do not accommodate requests for a different team member based on personal bias."
Colleagues can offer private support, reaffirming their allyship and checking in with the pharmacist after the incident. Workplaces must have clear policies to support staff in these situations, ensuring discriminatory requests are not tolerated.
Workplace Inclusivity
Many LGBTQIA+ pharmacists feel pressure to hide their identity due to workplace culture. While some environments are supportive, others make it difficult for pharmacists to be open about who they are.
A gay pharmacist avoids discussing his partner at work due to past negative reactions from colleagues. This leads to a sense of isolation and inauthenticity.
When workplaces foster inclusivity, LGBTQIA+ pharmacists feel safer and more engaged. Simple changes, like normalising discussions about diverse identities, can help create a culture of acceptance.
Workplace Culture
Workplace responses to LGBTQIA+ identity can vary. Some pharmacists have supportive managers and colleagues, while others face subtle discrimination or overt hostility.
A pharmacist was overlooked for a promotion after coming out as non-binary, with management citing ‘cultural fit’ concerns. These coded phrases are often used to justify bias.
Leadership accountability is crucial. When managers take discrimination seriously and promote inclusivity, workplace culture improves for everyone.
Mental Health Impacts
Studies show that LGBTQIA+ healthcare workers experience higher rates of anxiety, depression, and burnout due to workplace stressors.
The Conversation article (2024) highlights that transgender and gender-diverse Australians face significant mental health disparities, often linked to workplace discrimination.
A bisexual pharmacist left a toxic work environment because of ongoing microaggressions, realising that staying was harming her mental health.
Support networks, both inside and outside the workplace, play a vital role in mitigating these effects.
Support Systems
Clear anti-discrimination policies, diversity training, and visible support systems make a significant difference in creating inclusive workplaces.
A pharmacy that introduced LGBTQIA+ inclusivity training saw a dramatic improvement in workplace culture, with more staff feeling comfortable discussing issues of diversity.
Small changes, such as inclusive dress codes, gender-neutral restrooms, and allowing preferred names on ID badges, can make a workplace far more welcoming.
Addressing the Lack of Diversity, Equality, and Inclusivity in Pharmacy
The biggest gap in pharmacy is the lack of diversity, equity, and inclusion. While we receive extensive training on conditions like diabetes and cardiovascular diseases, there's often a significant blind spot in understanding the healthcare needs of marginalised communities, including LGBTQIA+ individuals.
This is not enough. Diversity, equity, and inclusion should be integrated into our practice from the start, embedded within curricula, professional standards, and workplace culture. We should train pharmacists to be not just medical experts, but also culturally aware, inclusive, and sensitive to the needs of all communities.
LGBTQIA+ people shouldn’t have to fight for a workplace that is accessible and affirming from the start. The workplace should be one where all individuals feel supported, respected, and empowered to thrive.
In conclusion, LGBTQIA+ pharmacists face unique challenges, but inclusive workplaces and supportive colleagues make a significant difference. By fostering open conversations, implementing strong policies, and promoting allyship, we can create safer and more welcoming environments in pharmacy.